1. In this systematic review and meta-analysis, exercise had a significantly positive effect on depressive symptoms.
2. In addition, exercise was found to be non-inferior to current first-line treatments for depression.
Evidence Rating Level: 1 (Excellent)
Exercise is well-known to be an effective adjunctive treatment for depression. Recently, several studies have investigated the relationship between exercise and depressive symptoms. As a result, the objective of the present systematic review and meta-analysis was to review the current evidence on the effects of exercise in reducing depressive symptoms in adults with clinical depression.
Of 15,734 identified records, 41 (n=2544) studies were included from various databases from database inception to September 2022. Studies were included if they investigated the role of exercise in treating depressive symptoms, used a validated depression scale, and included a non-exercise control group. Additionally, study participants had to be aged 18 years or older and have a diagnosis of major depressive disorder or dysthymia, or have depressive symptoms determined by validated screening measures. Studies were excluded if they used mind-body activities such as yoga or tai chi. The review was performed using PRISMA guidelines. Risk of bias was assessed using the revised Cochrane risk-of-bias tool for randomized trials. Statistical analyses were completed using random effects meta-analysis. The primary outcome was the mean change in depressive symptoms from baseline in the exercise group compared to the control group.
The results demonstrated that exercise had moderate to large effects on depressive symptoms compared to the control group. Furthermore, the role of exercise on depressive symptoms was significant in sub-group analyses, regardless of exercise type and depression classification. In addition, non-inferiority trials have demonstrated that exercise is non-inferior to current first-line treatments for depression. Despite these results, the review was limited by the heterogeneity of the included studies. Nonetheless, the present study synthesized the current literature and demonstrated the role of exercise in improving depressive symptoms.
Click to read the study in British Journal of Sports Medicine
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